Psychopaths' Brains Don't Grasp Punishment, Scans Reveal

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The brains of psychopathic violent criminals have abnormalities
in regions related to punishment that are not seen in the brains
of violent criminals who are not psychopathic, according to new
research using brain scans.

These MRI scans suggest that
psychopaths don't grasp punishment the same way as other
people, the researchers said. This is likely why psychopaths do
not benefit from rehabilitation programs, as other violent
criminals often do, the scientists report today (Jan. 28) in the
journal Lancet Psychiatry.

However, understanding these neurological
underpinnings of psychopathy may improve interventions during
childhood, when psychopathic behavior emerges as something
distinct from ordinary delinquency, the scientists said.

"Psychopathic offenders are different from regular criminals in
many ways," said Dr. Nigel Blackwood of King's College London, a
senior author on the paper. "Regular criminals are
hyper-responsive to threat, quick-tempered and aggressive, while
psychopaths have a very low response to threats, are cold, and
their aggressive behavior is premeditated."

To understand this difference, Blackwood and his colleagues
conducted MRI scans of the brains of 12 violent criminals with
psychopathy, 20 violent criminals with antisocial personality
disorder but not psychopathy, and 18 healthy people who were not
criminals. The criminals had been convicted of murder, rape,
attempted murder or grievous bodily harm in the United Kingdom.

While their brains were being scanned, the participants were
asked to play a matching game to assess their ability to change
their behavior when confronted with rewards and punishment.

In the group of criminals who were psychopathic, the scientists
observed lower volumes of gray matter in brain regions involved
in empathy,
moral reasoning, and the processing of social emotions such
as guilt and embarrassment. They also found abnormalities in
white matter fibers leading to the prefrontal cortex, in regions
involved in learning from reward and punishment.

The other violent criminals performed similarly to the people who
were not criminals in this test, the researchers found.

For any person, deciding on
how to behave involves generating a list of possible actions,
weighing the negative and positive consequences of each, and,
hopefully, choosing the behavior most likely to lead to a
positive outcome, explained Sheilagh Hodgins, a professor of
psychiatry at the University of Montreal, who co-led the study
with Blackwood.

"Offenders with psychopathy may only consider the possible
positive consequences and fail to take account of the likely
negative consequences," Hodgins said. "Consequently, their
behavior often leads to punishment rather than reward as they had
expected."

So, approaches to rehabilitation that are based on treating the
behavior problems of psychopaths similarly to those of criminals
who are not psychopathic are bound to fail, the researchers said.

"Offender rehabilitation focuses on changing behavior, but to
succeed it must take account of the personality characteristics
of the offenders," Hodgins told Live Science. "Those with
psychopathy are less empathetic, more callous, more
manipulative, and they commit more violent crimes, some of which
are premeditated."

What can be done to help psychopaths control their behavior? The
researchers suggest focusing on learning-based interventions
during childhood, when there still is the potential to alter
brain structure and function.

Hodgins said that researchers are "only beginning to learn about
the childhood antecedents of the syndrome of psychopathy," but
that her group's study provides a hypothesis on the emergence of
psychopathy and how to test for it in children.

There is ongoing research trying to understand how to help
children with psychopathic characteristics — that is, being
callous, unemotional and prone to disruptive conduct — to become
more emotionally responsive, Hodgins said. This may include
focusing on reward and using negative reinforcement sparingly
when interacting with these children.

"Since most violent crimes are committed by men who display
conduct problems from a young age, learning-based interventions
that target the specific brain mechanisms underlying this
behavior pattern and thereby change the behavior would
significantly reduce violent crime," Hodgins said.

But the abnormalities of brain structure and function associated
with persistent violent behavior are subtle and complex,
Blackwood added. And little is still known about how genes and
the environment conspire to create a cold, ruthless killer.